Financial hardship and pain among cancer survivors: a French nationwide cross-sectional analysis.

PURPOSE: The relationship between financial hardship and pain in cancer survivors remains poorly understood, with limited evidence linking financial hardship to pain outcomes.

METHODS

This nationwide web-based cross-sectional study examined the relationship between pain and financial hardship in French cancer survivors. Data were collected between January 27 and March 20, 2023, through 12 cancer associations and 12 Facebook groups. Primary outcomes were financial hardship (QLQ-C30) and pain status (BPI-SF). Secondary measures included pain characteristics, socio-professional categories and clinical factors, specific items of social precariousness, anxiety, depression, and health-related quality of life.

RESULTS

The sample included 1,012 survivors (82.6% female; mean age 55.2 ± 11.1 years), with breast cancer the most frequent (61.6%), and 50.4% undergoing anticancer treatment. Financial hardship was more prevalent among those with pain (OR: 2.7, 95% CI [2.1-3.6]), and financial hardship scores correlated with pain scores (Spearman's rho: 0.28, p < 0.001). Multivariate analysis confirmed associations between financial hardship and pain severity (mild pain: OR: 1.57, 95% CI [1.08-2.29]; moderate pain: OR: 2.12, 95% CI [1.43-3.13]; severe pain: OR: 2.87, 95% CI [1.59-5.16]), particularly among individuals who had completed anticancer treatment, as well as with younger age, living alone, anxiety, depression, and socio-professional categories such as entrepreneurs, employees, and unemployed individuals.

CONCLUSIONS

Financial hardship is associated with pain severity. Younger survivors, those living alone, those with psychological distress, and those post-treatment seem more vulnerable. These findings emphasize the need for targeted interventions and research to reduce financial and psychosocial disparities in cancer survivorship.